Publication Of Survival Benefit In Leading Journal Emphasizes Importance Of Erbitux In 1st Line MCRC
Merck Serono, a division of Merck KGaA, Darmstadt, Germany, today announced that an updated analysis of the Phase III CRYSTALa study has been published in the latest edition of the Journal of Clinical Oncology. The analysis included the evaluation of overall survival (OS) according to KRAS mutation status in patients with metastatic colorectal cancer (mCRC), and found that the addition of Erbitux® (cetuximab) to standard chemotherapy (FOLFIRI) in patients with KRAS wild-type disease resulted in a significant improvement in OS of 3.5 months, compared with FOLFIRI alone.1 CRYSTAL is the only trial to date to demonstrate a significant overall survival benefit of a targeted therapy in combination with current standard chemotherapy (FOLFIRI) in 1st line treatment of mCRC.
“It was rewarding for the results of CRYSTAL to not only show an improved response rate, but also improved overall survival. The importance of these results is recognized by the oncology community through publication in this prestigious journal,” said Professor Eric Van Cutsem, lead investigator of the CRYSTAL study and Professor of Medicine and Digestive Oncology from the University Hospital Gasthuisberg in Leuven, Belgium. “CRYSTAL has proven to be a landmark study in colorectal cancer through the scientific knowledge it has delivered to the oncology community, helping to catapult the practice of personalized medicine forward.”
CRYSTAL is a multicenter, Phase III, randomized, controlled trial involving 1,198 patients and investigating the efficacy and safety of Erbitux in combination with FOLFIRI vs. FOLFIRI alone in the 1st line treatment of patients with mCRC. “CRYSTAL was the first Phase III trial to demonstrate the significance of the KRAS biomarker in 1st line mCRC. The findings have since led to a critical shift towards more personalized management of this disease and, most importantly, to improved outcomes for patients,” added Dr. Wolfgang Wein, Executive Vice President, Oncology, Merck Serono. “We are proud of the contribution the study has made to science and to patient care.”
The top-line CRYSTAL results1 in patients with KRAS wild-type tumors (n=666) receiving Erbitux plus FOLFIRI are:
- Median OS was 23.5 months compared to 20.0 months in those receiving chemotherapy alone (Hazard Ratio [HR] 0.796; p=0.0093)
- The risk of disease progression was reduced by 30.4% (HR 0.696; p=0.0012)
- The likelihood of achieving a tumor response doubled overall (Odds Ratio [OR] 2.0693; ORR 57.3% vs. 39.7%; p<0.001)
In 2008, the CRYSTAL study was recognized by the American Society of Clinical Oncology (ASCO) as one of the “major clinical cancer advances” for the year.
More than 370,000 people develop colorectal cancer in Europe every year, accounting for 13% of the total cancer burden and around 200,000 deaths.3 Approximately 25% of patients present with metastatic disease,4 and 5-year survival rates for patients with mCRC can be as low as 5%.5
References
1.Van Cutsem E, et al. J Clin Oncol 2011 Apr. 10.1200/JCO.2010.33.5091
2.Winer E, et al. J Clin Oncol. 2009 Feb 10;27(5):812-26. See here.
3.Parkin DM, et al. CA Cancer J Clin 2005;55:72-108.
4.Cunningham D, et al. Eur J Cancer 1993;29A(15):2077-2079.
5.Macdonald JS. CA Cancer J Clin 1999;49(4):202-219.
aCRYSTAL: Cetuximab combined with iRinotecan in first line therapY for metaSTatic colorectAL cancer
About Erbitux
Erbitux® is a first-in-class and highly active IgG1 monoclonal antibody targeting the epidermal growth factor receptor (EGFR). As a monoclonal antibody, the mode of action of Erbitux is distinct from standard non-selective chemotherapy treatments in that it specifically targets and binds to the EGFR. This binding inhibits the activation of the receptor and the subsequent signal-transduction pathway, which results in reducing both the invasion of normal tissues by tumor cells and the spread of tumors to new sites. It is also believed to inhibit the ability of tumor cells to repair the damage caused by chemotherapy and radiotherapy and to inhibit the formation of new blood vessels inside tumors, which appears to lead to an overall suppression of tumor growth.
The most commonly reported side effect with Erbitux is an acne-like skin rash that seems to be correlated with a good response to therapy. In approximately 5% of patients, hypersensitivity reactions may occur during treatment with Erbitux; about half of these reactions are severe.
Erbitux has already obtained market authorization in 87 countries. It has been approved for the treatment of colorectal cancer in 87 countries and for the treatment of squamous cell carcinoma of the head and neck (SCCHN) in 84 countries:
- December 2003 (Switzerland), February 2004 (USA), June 2004 (EU) and followed by other countries: for use in combination with irinotecan in patients with EGFR-expressing mCRC (metastatic colorectal cancer) who have failed prior irinotecan therapy. In addition, Erbitux is also approved for single-agent use in further countries.
- March 2006 (EU) and followed by other countries: for use in combination with radiotherapy for the treatment of locally advanced squamous cell carcinoma of the head and neck (SCCHN). In further countries, Erbitux is also approved as monotherapy in patients with recurrent and/or metastatic SCCHN who failed prior chemotherapy.
- July 2008 (EU): license was updated for the treatment of patients with epidermal growth factor receptor (EGFR) expressing, KRAS wild-type mCRC in combination with chemotherapy and as a single agent in patients who have failed oxaliplatin-and irinotecan-based therapy and who are intolerant to irinotecan.
- July 2008 (Japan): for use in combination with irinotecan in patients with EGFR-expressing mCRC who have failed prior irinotecan therapy
- In November 2008 (EU): license was updated for the use in combination with platinum-based chemotherapy in patients with recurrent and/or metastatic SCCHN
- March 2010 (Japan): label extended to use in combination with chemotherapy in the 1st-line treatment for patients with epidermal growth factor receptor (EGFR)-expressing, curatively unresectable (inoperable), advanced or recurrent colorectal cancer (mCRC) carrying the KRAS wild-type gene.
Merck licensed the right to market Erbitux outside the US and Canada from ImClone LLC, a wholly-owned subsidiary of Eli Lilly and Company, in 1998. In Japan, ImClone, Bristol-Myers Squibb Company and Merck jointly develop and commercialize Erbitux. Merck has an ongoing commitment to the advancement of oncology treatment and is currently investigating novel therapies in highly targeted areas, such as the use of Erbitux in colorectal cancer, squamous cell carcinoma of the head and neck and non-small cell lung cancer. Merck has also acquired the rights for the cancer treatment UFT® (tegafur-uracil) – an oral chemotherapy administered with folinic acid (FA) for the first-line treatment of metastatic colorectal cancer.
Merck is also investigating among other potential cancer treatments the use of Stimuvax® (BLP25 Liposome Vaccine) in the treatment of non-small cell lung cancer. The vaccine was granted fast-track status in September 2004 by the FDA. Merck obtained the exclusive worldwide licensing rights from Oncothyreon Inc., Seattle, Washington, USA.
In addition, Merck is developing cilengitide, which is the first in a new class of investigational anti-cancer therapies called integrin inhibitors to reach Phase III development; it is currently being investigated for the treatment of glioblastoma, SCCHN and NSCLC. Integrin inhibitors are thought to work by targeting the tumor and its vasculature.
Source:
Merck Serono
Merck